Provider Demographics
NPI:1972601714
Name:GARCIA, MELINDA A (DDS)
Entity Type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:A
Last Name:GARCIA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MELINDA
Other - Middle Name:A
Other - Last Name:PETERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:7427 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:PRAIRIE VILLAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66208-2862
Mailing Address - Country:US
Mailing Address - Phone:913-787-1163
Mailing Address - Fax:
Practice Address - Street 1:7930 LEE BLVD
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66206-1215
Practice Address - Country:US
Practice Address - Phone:913-383-5373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2015-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSKS60390122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist